Understanding risk adjustment and compliance for outpatient CDI

February 7, 2018
HIM Briefings

Organizations and CDI specialists must have a thorough understanding of how regulations and guidelines impact risk adjustment in the outpatient setting. A misinterpretation can easily lead to inadvertent upcoding—and that can lead to costly audits, settlements, and accusations of fraud.

How to avoid coding issues during EHR implementations

February 14, 2018
HIM Briefings

The implementation of an EHR is a multifaceted, comprehensive project for healthcare organizations. To avoid coding issues during EHR implementation and ensure discharged-not-final-coded is not adversely impacted, dedicated HIM focus and detailed project planning are paramount.

Computer-assisted coding: New techniques to improve accuracy

February 28, 2018
HIM Briefings

In advance of ICD-10-CM/PCS, many institutions implemented computer-assisted coding (CAC) hoping to mitigate the anticipated productivity losses, but research has confirmed suspicions that there is an inverse relationship between coding productivity and accuracy.

Documentation and ICD-10-CM/PCS affects readmission rates

February 28, 2018
HIM Briefings

CMS, the Veterans Health Administration, and some states measure our care quality based on risk-adjusted readmission rates after inpatient admissions. In fact, up to 3% of our hospital’s Medicare inpatient revenue (used to pay physician subsidies) is at risk if we don’t manage our patients’ readmissions in concert with Medicare’s algorithms.